Psychiatric sequelae of traumatic brain injury (TBI) can cause significant and often chronic impairment in functioning and quality of life; however, their phenomenological and mechanistic complexities continue to present significant treatment challenges. The clinical presentation is often an amalgam of syndromes and co-occurring symptoms that require a highly nuanced and systematic approach to treatment. Although few randomized controlled trials have tested treatments for psychiatric problems after TBI and the synthesis of results continues to be compromised by the heterogeneity of study populations, small samples, and differing inclusion criteria and outcome measures, an increasing body of literature supports evidence-based treatment strategies. We provide a narrative review of pharmacological, psychoeducational/behavioral, and neuromodulation treatments for psychiatric conditions in adults with TBI and discuss known or postulated mechanisms of action for these treatment approaches. Where data are available, we focus on randomized controlled trials and large case series in which a psychiatric condition provides both a selection criterion and a primary or secondary outcome. We conclude by proposing directions for future research, particularly the need for novel neuropharmacological, behavioral, and neurophysiological studies and pragmatic trials of multicomponent and adaptive models that will increase understanding of the mechanisms underlying post-TBI psychiatric disorders and accelerate dissemination and implementation of effective person-centered care.

创伤性脑损伤 (TBI) 的精神病后遗症可导致功能和生活质量严重且通常为慢性损害；然而，它们的现象学和机械复杂性继续给治疗带来重大挑战。临床表现通常是综合征和同时出现的症状的混合体，需要高度细致和系统的治疗方法。尽管很少有随机对照试验测试了 TBI 后精神问题的治疗方法，并且结果的综合继续受到研究人群的异质性、小样本以及不同的纳入标准和结果测量的影响，但越来越多的文献支持循证治疗策略。我们提供药理学、心理教育/行为、和神经调节治疗成人 TBI 的精神疾病，并讨论这些治疗方法的已知或假定作用机制。在可获得数据的情况下，我们专注于随机对照试验和大型病例系列，其中精神疾病提供选择标准和主要或次要结果。最后，我们提出了未来研究的方向，特别是对新的神经药理学、行为学和神经生理学研究以及多组分和适应性模型的实用试验的需求，这将增加对 TBI 后精神疾病潜在机制的理解，并加速有效人的传播和实施——以护理为中心。